Project Summary/Abstract Synthetic arteriovenous grafts (AVGs) can provide life sustaining vascular access for dialysis patients, but are subject to multiple modes of failure and complications related to chronic needle cannulation, poor graft identification, delayed access, and bleeding. These graft/needle cannulation associated complications translate to millions of dollars in health care expenses, hospitalizations, pain and suffering. To address this problem, we have developed an immediate access hemodialysis graft that assures routine, error free, successful cannulation and prevents graft injury; the Bullet Proof vascular graft. This novel graft has been designed to be hemostatic, durable, easily identifiable and usable by dialysis technicians and patients alike. In preliminary testing, the Bullet Proof graft has been shown to be hemostatic, self-sealing, resistant to posterior and sidewall penetration, and more durable than current standard and ?early access? dialysis grafts available for clinical use. In this Phase I STTR application, we will improve upon the current design of the Bullet Proof vascular graft (Aim 1) and will conduct a series of rigorous experiments to validate our pilot studies. These experiments will consist of bench top testing designed to evaluate the self-sealing, resistance to back wall penetration, and overall graft durability of our graft design when compared to that of the leading standard and ?early access? vascular access grafts on the market today (Aim 2). The safety and effectiveness of our graft design will also be tested in vivo using a porcine dialysis graft cannulation model (Aim 3). In these experiments, test and control grafts will be implanted and cannulated for up to 20 weeks and evaluated for overall graft patency, time to hemostasis, and resistance to posterior graft wall injury. Successful completion of this Phase I STTR project will result in an improved version of the Bullet Proof AVG, approaching a finalized, manufacturable design, validation of the key design attributes of the graft, and verification of the safety, efficacy, and patency of this novel dialysis graft technology.